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Dr. Tom, Board Certified MD

Category: Eye

Satisfied Customers: 264

Experience: 30 years experience treating patients with eye problems

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Constant eye pain, since blended lasik (both) surgery.

Customer Question

Just over 5 months ago I had blended lasik on both eyes. I have constant pain, especially in one eye. I also experience light sensitivity (I wear sunglasses almost all the time), dry eyes that sometimes feel "cold/menthal like". My vision is still blurred. What can be done to remove these conditions. I am getting worn down, moving to depression. The eye (left) that is to see far is clear when I close my right eye. And the eye (right) that is to see up close sees clearly when I close my left eye. However, when I use both eyes at the same time there is a halo/blurr around everything. Also, during the surgery the doctor pressed down (jerk motion) on my left eye (during process to flatten the eye). My left eye had been bruised. I will get pain (like a strain) in my left eye, and the area under my eye is swollen and dark. My right eye does not have this.

Hi, I'm online now and would be happy to help you with your question.I understand what you are asking. Just reply and we'll get started. Dr. Tom

Dr. Tom :

Thank you for your question. I'm sorry you're having such a tough time. Five months is a long time to wait for improvement. From reading your question a couple of times, it sounds like you are dealing with two different issues. Your first point was that you are in constant pain and light-sensitive. Since you know that you have a problem with dry eyes, and you probably know that it is often made more difficult following LASIK, it will probably be necessary for you to to do more than just use artificial tears. You did not mention any prior use of Restasis. It is certainly something to consider. Another product that I have found very effective is a nutritional supplement made by a company called Biosyntrix. The product is called Biotears. It specifically focuses on anti-inflammatory aspects of mucous membranes, and in the experience of many physicians, it really hits the nail on the head. It is a two capsule, two times a day supplement. At the end of this answer I will give you a website. It has been very effective in my patients ( and me personally) with similar problems as yours. And for a very small group of patients, there is an evolving field in the management of corneal diseases known as Autologous PRP Eye Drops PLATELET RICH PLASMA (PRP). I do not know if PRP is available in Canada, but I will give you a website in the USA for that as well. .............................. So overall, it would appear that if you could get your ocular surface and comfort under control, you probably will be fine with the blended ( one eye for distance one for near) outcome of your Lasix procedure ., particularly if you were successful as a Mono fit contact lens wearer before Lasix.

Dr. Tom :

I hope this has been of help to you, offers you an answer. Please let me know if you have any other questions.

I will look for Restasis and Biotears. Following are some concerns I'd like you to answer.

1) The ache in my left eye feels like it comes from deeper in the eye. The eyeball is also sensitive to any pressure if I touch it. There is also swelling and dark circles under that eye. Why is this happening? Could it be eye strain? To relieve the pain, | rest my eyes. To hide the swelling and dark circle I use cosmetics. Will this pass over time?

2) My left eye (far) eye sees to "repel" off the surface of close objects (as I read, write, eat, etc). This causes a halo and blur as if I'm looking through a wet window). As my brain adjusts will this disappear? Likewise, my right (near/close) eye keeps me from seeing medium or far objects clearly (much like above wet window/halo) and I find malls and such places overwhelming in straining to see and to orientate myself. I do not drive my car for this reason. What is this? Will it disappear over time? How long should it take.

3) Even when both eyes are lubricated (I can feel moisture in the eyes) they still burn and feel very sore (sometimes my left eye is extremely painful and burns more that the right eye at those times). I assume this isn't dry eye? Is the surface of my eye healing and therefore experiencing pain? I almost always must wear dark glasses, even in darker rooms.

Please explain what you think it could be and how I can treat it.

4) How do I know if my eyes and brain just need more time to heal and adjust or if it needs correcting? I was not a contact lens wearer, not was it suggested to me by the surgeon. My prescription was in the -6 to -7 range prior to the blended surgery. I had worn progressive glasses with no problem. I've also worn glasses for over 50 years.

5) How long can it take before both eyes are working together? The surgeon said the left eye sees far but "helps" the right, and the right sees near but "helps" the left. so far, both eyes see clearly on their own but the opposite happens when trying to see using both together.

These are all the concerns I can think of at the present. If there is more I hope to ask while we are in contact. Since I am quite distressed over all this, I greatly appreciate all help to see clearly and as painlessly as I had been promised.

Thank you.

Kind regards.

Mary-xxxxx

P.S. This was typed by my husband because I cannot see well enough to do it myself.

That's a lot of questions in one posting, but let's see if I can pull all of this together. But before I do, remember, without an examination and actual measurrements and without the opportunity to evaluate your corneas, an internet chat is for information only. We can not diagnos or treat without establishing a doctor-patient relationship...and that requires a physical exam.

Questions 1-3 relating to pain are very likely the result corneal surface disfunction ( it can be called "dry eye" , but it's really all about poor tear film stability) . Without good tearfilm function, microscopic defects develope in the corneal epithelial cells and these expose corneal nerve ending. So most all of your pain, light sensitivity, darkening of the periocular lid skin and even your " halo and blur " can be caused by this.

Questions 4-5. These are related to your lack of adaptation to the " blended" post operative refractions of your eyes, or monofit ( if you had tried it first with contacts).

Five months would normally be adequate for adaptation. But again, it sounds like the ocular surface problem needs to be adequately addressed.

I hope this has been useful. I look forward to hearing how you do. Best wishes.

Dear Dr.Tom,Thank you so much for all the help and information. I will rate your service as soon as I can get on line. I can't seem to access through my phone.I do need to clarify some information. I ordered the supplement and will start when it arrives. I need a prescription for the Restasis. Is it nessary to get the Restasis? Should I take the supplement and see how it goes,then get the Restasis if I still need help?My surgeon is not forthcoming on information or helpful with the problems I'm having. Thank-you,Mary-Ann

Regarding Restasis..........the vast majority of my patients (including myself) have not needed Restasis once established on Biotears.....so just hold off on the RX. Yes....just see how it goes.....you might add the Restasis later.

If you are getting this email, you should be able to click on one of the positive replys to rate our encounter. Best wishes and keep in touch about your results. Thanks.

I have seen my doctor and he told me that he doesn't see any dry spots in my eyes and therefore I do not have dry eye. I had ordered the Biotears and am hesitant to use the supplement since it appears to be used for dry eye. I had thought it was to heal, so now I don't know what to do. The doctor couldn't get a good reading on my vision so is waiting another month. He said that will determine if I need a minor correction in my left eye. The left eye is the distance one, has been the more painful, repels when i look up close, and has the swollen,dark circle underneath. So, I need to know if I should still take the Biotears (I had bought two bottles and received both yesterday)or just let my eyes keep adjusting on their own. They are still stinging and my vision is still blurred but there may be marginal improvement. It's hard to tell. I don't use any drops (my doctor told me not to) and my own tears seem to be lubricating my eyes. I still wear my sunglasses although I try to go for little time periods without, and use wet compresses when I need to.

Please advise. Would taking the Biotears interfere,as explained above, or just add extra nutrients in the healing. Thank you for your help thus far.

Symtomatic " dry eye" or ocular surface inflamatory problems don't always have dry spots on the microscopic exam...yet patients can be very symtomatic. Since I can't examine you and establish a proper doctor-patient relationship, I can not give you medical advice. However there is not likely to be any ocular down side to using nutritional support. Best wishes.

I will tell you that...the things you have to go through to be an Expert are quite rigorous.

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